Jungle foot, also known as immersion foot or trench foot, is an injury of the feet caused by prolonged exposure to wet and cold conditions. It was first observed during World War I with soldiers stuck in trenches filled with water for long periods of time. Since then, it has been seen in other populations like hikers, fishermen, and homeless people exposed to damp cold environments for days or weeks at a time.
What causes jungle foot?
Jungle foot is caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions. Exactly how long it takes to develop jungle foot depends on the temperature, but it can occur in as little as a few hours if the conditions are cold enough. The cold causes constriction of blood vessels in the feet and reduces blood circulation. The wetness also leads to softening and eventual damage of the skin. Together, these make the feet susceptible to infection.
The cold, wet conditions affect the feet in several ways:
- Reduced blood flow – Vasoconstriction decreases nutrient and oxygen supply to feet tissues
- Nerve damage – Both sensory and motor nerves start malfunctioning
- Tissue injury – Prolonged wetness leads to softening and damage of skin and underlying tissues
- Infection – Broken skin allows entry of bacteria, fungi, and other microbes
These processes can progress to necrosis (tissue death) if jungle foot is unchecked. The unsanitary, wet conditions provide an ideal breeding ground for bacteria and fungi as well.
What are the symptoms of jungle foot?
The symptoms of jungle foot tend to follow a progressive pattern, beginning with less severe symptoms that worsen over time. The stages include:
- Pins and needles sensation – The feet feel numb and tingling due to nerve damage and impaired blood circulation.
- Burning and itching – As nerve endings start reviving, burning and itching sensations begin.
- Swelling – The feet become edematous and swollen due to fluid buildup.
- Blisters/bleeding – Prolonged wetness causes the skin to become soggy and bleed.
- Necrosis – Severe and prolonged lack of oxygen can lead to cell death and gangrene.
As the condition worsens, walking becomes increasingly painful. There may also be foul odor from infected sores or gangrene. Systemic signs like fever, chills, and fatigue may be present if the infection spreads beyond the feet.
Who is at risk for jungle foot?
Anyone exposed to prolonged cold and damp conditions can be affected by jungle foot. However, certain populations are at higher risk:
- Military personnel – Especially infantry units operating in wet terrain
- Homeless people – Due to lack of dry shelter
- Hikers/campers – Particularly in cold, rainy weather
- Flood victims
- Fishermen working on wet boats
- Athletes using tight, waterlogged shoes over long periods
Other risk factors include smoking, diabetes, peripheral vascular disease, malnutrition, and wearing constrictive footwear that reduces circulation.
How is jungle foot diagnosed?
Jungle foot is primarily diagnosed based on the history of exposure to cold, damp conditions. The doctor will ask about the environment, duration of exposure, and any activities that caused repeated wetting of the feet.
Physical examination shows typical features like:
- Pale, wrinkled skin
- Edema
- Blisters and open sores
- Peeling skin
- Gangrene in severe cases
There are no specific diagnostic tests for jungle foot. Laboratory culture of wound drainage can identify any secondary bacterial or fungal infection. Imaging studies like X-ray and MRI may be done to assess any bone or tissue damage in severe cases.
What is the treatment for jungle foot?
The key principles of treating jungle foot are:
- Removing wet shoes/socks and drying the feet – Feet should be thoroughly cleaned and dried. All wet gear must be changed.
- Gradual rewarming – Active external heating should be avoided as it can cause burns. Feet are rewarmed passively after drying.
- Elevation – Keeping the feet raised above heart level helps reduce swelling.
- Pain relief – Medications like ibuprofen and topical anesthetics provide analgesia.
- Preventing infections – Antibiotics, antifungals, and tetanus immunization target infections.
- Surgical debridement – In severe cases, gangrenous tissue is surgically removed to prevent spreading.
Other supportive measures include adequate hydration, nutritional support, and skin care. Strict feet hygiene must be maintained after the initial healing to prevent recurrence.
Are there any complications of jungle foot?
The main complications that can arise from jungle foot include:
- Cellulitis – Bacterial skin infection spreading across feet
- Osteomyelitis – Infection of foot bones
- Gangrene – Death of foot tissues
- Sepsis – Systemic inflammatory response to infection
- Chronic non-healing ulcers
- Permanent nerve damage
- Amputation in severe cases
These complications can be minimized with prompt treatment. But if jungle foot is left untreated, it can progress and lead to permanent disability or even death in rare cases.
How can jungle foot be prevented?
Preventing jungle foot requires paying close attention to feet hygiene when spending prolonged time in damp cold environments. Recommended preventive measures include:
- Keeping feet dry – Have multiple pairs of socks/shoes to rotate.
- Frequent changing of socks – Wet socks must be taken off as soon as possible.
- Proper drying of feet – Feet should be cleaned and dried thoroughly once wet.
- Waterproof shoes/boots – Prefer high rubber boots to keep water out.
- Barrier creams – Petroleum jelly reduces moisture damage.
- Adequate insulation – Use insoles and several sock layers to keep feet warm.
- Good hydration and nutrition – Maintain adequate circulation.
- Skin inspection – Check feet daily for any signs of injury.
Soldiers and hikers should be educated on early recognition and first aid for jungle foot when operating in wet environments.
| Stage | Signs and symptoms |
|---|---|
| 1 | Pins and needles, numbness, itching |
| 2 | Burning pain, swelling, reddening |
| 3 | Blisters, skin thickening, shedding skin |
| 4 | Ulcers, gangrene, foul odor |
Key Points
- Jungle foot is caused by prolonged exposure of feet to damp, cold conditions, damaging skin and tissues.
- Early symptoms include numbness and tingling, progressing to blisters, necrosis and gangrene.
- Populations like soldiers, hikers, homeless people are at highest risk.
- Treatment involves drying the feet, rewarming, antibiotics, and surgical debridement.
- Prevention centers on keeping feet dry, insulation, and frequent hygiene.